• A Green, R Lyus, M Ocan, A M Pollock, and P Brhlikova.
• Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK.
• J R Soc Med. 2023 Oct 1; 116 (10): 331342331-342.

ObjectivesTo audit national drug registers (NDRs) in Kenya, United Republic of Tanzania and Uganda with respect to national Essential Medicine Lists (EMLs) and to conduct an analysis of highly registered products including a sub-analysis of highly registered antimicrobial products.DesignRetrospective analysis of registration of essential medicines and medicinal products on NDRs as of February 2018.SettingNot applicable.ParticipantsNone.Main Outcome MeasuresRegistration status of essential medicines by country, essential medicine status of registered products by country and medicines with more than 50 registrations across all three countries.ResultsA high proportion of essential medicines are not registered: Kenya 28% (175/632), United Republic of Tanzania 50% (400/797) and Uganda 40% (266/663). Of registered products on the NDRs, more than half are not essential: Kenya 71% (4350/6151), United Republic of Tanzania 64% (2278/3590) and Uganda 58% (2268/3896). When the three NDRs were combined, there were 42 medicines with over 50 registered products, accounting for 30% (4153/13637) of products, many of which were non-essential.ConclusionsNon-registration of essential medicines is a barrier to availability. Over-registration of medicines, particularly non-essential medicines, diverts regulatory resources towards registering non-priority and, sometimes, clinically sub-optimal medicines. The East African Community Medicines Registration Harmonization Project has the potential to improve access to key medicines if registration of essential medicines is prioritised and registration of non-essential medicines is restricted.

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